In vitro optical performance of multifocal and extended depth-of-focus intraocular lenses in spherical aberration conditions

Purpose: To evaluate and compare the optical performances of 4 different types of intraocular lenses (IOLs) in various spherical aberration (SA) conditions. Setting: POSTECH, Pohang, South Korea. Design: In vitro laboratory study. Methods: A custom optical bench system with adaptive optics was used. A monofocal IOL, a bifocal IOL, a trifocal IOL, and an extended depth-of-focus (EDoF) IOL from Zeiss were evaluated by measuring through-focus modulation transfer function (MTF) as a function of vergence. MTF changes with SA from −0.1 to +0.1 with 0.05 μm step size were analyzed and compared. Results: In aberration-free conditions, the 4 IOLs showed different MTF curves consistent with their designs. In SA conditions, all the IOLs showed MTF value decreases and the decrease rates at the far focus varied from 28% to 38% per 0.1 μm SAs. The trifocal IOL had low MTF values at the intermediate focus in the noise level with ±0.1 μm SAs. Conclusions: All tested IOLs showed MTF decreases with SA in different levels. The trifocal and EDoF IOLs were the most and least sensitive to SA among the evaluated IOLs. The study results might be useful in the selection of IOLs for cataract patients with SA.